Short- and Long-Term Donor Outcomes After Kidney Donation: Analysis of 601 Cases Over a 35-Year Period at Japanese Single Center
Short- and Long-Term Donor Outcomes After Kidney Donation: Analysis of 601 Cases Over a 35-Year Period at Japanese Single Center
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DOI：
10.1097/tp.0b013e318192dc95
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发表时间：
2009-02-15
期刊：
影响因子：
6.2
通讯作者：
Yoshimura, Norio
中科院分区：
文献类型：
--
作者：
Okamoto, Masahiko;Akioka, Kiyokazu;Yoshimura, Norio
背景。在日本，由于缺乏已故捐赠者，这意味着在多达80%的病例中，活体肾脏移植是必要的。然而，关于活体肾供者围手术期并发症和长期预后的数据很少。为了确定活体肾供者围手术期的相关发病率和长期死亡率，我们回顾了1970年至2006年间在我院施行的601例肾供者切除术，并试图联系所有肾供者（或其家属）以确定其目前的身体状况。生存率和死亡原因与一般人群中年龄和性别匹配的队列进行比较。虽然3名供者（0.5%）出现了主要的围手术期并发症，即股神经压迫、肺血栓形成和急性肾功能衰竭，但所有供者均康复出院，无并发症。在检查时可获得详细信息的481名捐赠者（80%）中，426名（88.5%）仍然存活。5年、10年、20年和30年的供体生存率分别为98.3%、94.7%、86.4%和66.2%。肾脏捐献与死亡之间的平均间隔为183 +/- 102（7-375）个月，平均死亡年龄为70 +/- 11岁。肾脏供者的存活率高于年龄和性别匹配的普通人群，死亡模式和原因相似。我们的数据表明，从短期和长期的供体安全性来看，继续进行活体肾移植项目是合理的。
Background. The lack of deceased donors in Japan means that living-donor kidney transplantation is necessary in as many as 80% of cases. However, there are few data on perioperative complications and long-term outcome for live kidney donors.Methods. To determine associated perioperative morbidity and long-term mortality among live kidney donors, we reviewed 601 donor nephrectomies performed at our institution between 1970 and 2006 and attempted to contact all of the donors (or their families) to ascertain their present physical status. The survival rate and causes of death were compared with an age- and gender-matched cohort from the general population.Results. Although three donors (0.5%) experienced major perioperative complications, that is, femoral nerve compression, pulmonary thrombosis, and acute renal failure, all of the donors recovered and left hospital without complications. Among 481 donors (80%) for whom details were available at the time of inspection, 426 (88.5%) were still surviving. Donor survival rates at 5, 10, 20, and 30 years were 98.3%, 94.7%, 86.4%, and 66.2%, respectively. The mean interval between kidney donation and death was 183 +/- 102 (7-375) months, and the mean age at death was 70 +/- 11 years. The survival rate of kidney donors was better than the age- and gender-matched cohort from the general population, and the patterns and causes of death were similar.Conclusions. Our data suggest that continuation of living-donor kidney transplantation programs is justified in short- and long-term donor safety.